You need to be sure!
The purpose of a vasectomy is to be Permanent. If you are considering to have a reversal done in the future, then do not even consider getting a vasectomy done ... at all !
A vasectomies takes at least 3 months before it works ... and maybe longer.
You need to do a semen test before you can have sex without any other contraception.
What you need to know before signing on the dotted line.
For all intentions you should consider that a vasectomy is PERMANENT.
The purpose of a vasectomy is to ensure that you will not conceive another child in the future.
So, if you feel that you have had all the kids you ever wanted to have, then this is the right procedure for you.
Vasectomy Reversal Procedures are often not successful, are very expensive and, in Canada, is not funded by your provincial or extended health care. Therefore, I need you to be sure that this is the FINAL STEP!
Vasectomies has a long term failure rate of 1:2000.
That means that for every 2000 guys who have achieved a zero sperm count following a vasectomy, there will be one guy that will still conceive a child in the future. This can happen anytime in your life, even as much as 20 years after your vasectomy.
This may happen because of a spontaneous reversal. We don't know why this may happen, but it is just one of those things that you have to accept.
So, if your partner one day comes home stating that she is pregnant, then you cannot immediately assume it is not your child because you had a vasectomy.
You may then want to consider doing a semen analysis and even a paternity test, if you feel that is needed.
Once we cut through the tubes (vasa), there are still sperm sitting in the upper part of the tubes. For the average guy it takes a minimum of 3 months to clear out that sperm.
For a minimum of three months you need to consider yourself fully fertile. You still need to use contraception and do not stop using contraception until you have done your follow up semen analysis test.
If by three months you have a zero sperm count, then and only then, will we consider your vasectomy successful and then you may stop using contraception.
If by three months you still have sperm in your semen, then we need to wait another three months to retest and we continue to retest every three months, until we have a zero sperm count.
On average 1 in 10 guys need to wait until 6 months before they have a zero sperm count.
1 in a 100 guys need to wait until 9 months before they have a zero sperm count.
1 in 500 guys will still have sperm by the 12 month mark. By that time we will consider this an early failure or a so called early recanalization and then we can talk about your options. One of your options could be to redo the vasectomy.
The bottom line is this: DO NOT TRUST THAT YOU HAVE A SUCCESSFUL VASECTOMY UNTIL YOU HAVE A ZERO SPERM COUNT AND I HAVE TOLD YOU IT IS OKAY!
Failure rate of vasectomies.
Vasectomies are NOT effective immediately
Complications of vasectomies.
All medical procedures have potential complications. Overall the chance of you having any complication due to a vasectomy is very little and this is still considered one of the safest surgical procedures. The following is a few things you do need to know about:
- You can get bleeding into your scrotum
Whenever you may have heard about a guy who got big "grapefruit nuts" after a vasectomy, it was most likely due to internal bleeding into the scrotum. When this happens it can cause you lots of pain and slow down your healing for several weeks. Therefore this is the number one thing I would like to avoid.
Your chance of getting bleeding is minimal as long as you are going to follow the preparation instructions, as well as the aftercare instructions. But it only works if you follow these instructions.
2. You can get infection.
This can happen with any surgery. And of course we try to ensure that we do everything sterile to prevent infections. However, if you do get an infection, it usually responds rapidly to a course of antibiotic, if required.
My overall rate of infection is very low. Less than 1:300.
3. You can get a Post-Vasectomy Granuloma.
This is the most common complication that can happen. This affects on average 4% of men.
This is a delayed inflammation reaction.
Typically these guys feel fine after their surgery and will heal up just as expected, but then a while later ranging from just a few days to as much as six weeks after the surgery, these guys will suddenly develop a painful lump and swelling around the spot where we did the procedure.
Because this is a inflammation response, we will typically treat these guys with an anti-inflammatory like Ibuprofen and this will dissolve the inflammation tissue and make everything go back to normal within one or two days, without any further consequences.
4. Chronic Post-Vasectomy Pain Syndrome.
This is the only potential long term complication of vasectomies, but thankfully this is a very rare complication. This incidence is on average 1 in every 1000 guys.
The exact reason why some guys get chronic pain after a vasectomy is not clearly understood, but the common believe is that this is caused by scar tissue that forms around the nerve bundle and when these guys do certain activities (like sports) then this scar tissue pulls on these nerves, causing them an uncomfortable feeling into the groin. This can happen recurrently for several months or even several years.
Unfortunately we can not predict who is going to experience this as I will do this procedure exactly the same way for 1000 guys and only one guy will experience this.
The other unfortunate part is that there is very little we can do about this. We certainly can not go do more surgery, as this will cause more scar tissue, which is thought to be the cause in the first place.
The reassuring part is that this discomfort typically does not last forever. It seems to go away with time, but may hang around for a few months or even a few years. And typically this is not described as a severe agonizing pain, but more often described as a nagging discomfort.
If you experience any complications following your vasectomy, then please feel free to contact me.
How do you prevent complications?
The most important step to prevent complications is to follow the Preparation Instructions as well as the After-Care Instructions.